ES2961688T3 - Analysis of patient care - Google Patents

Abstract

A method, system, and computer-readable medium is provided for determining compliance with patient care protocols, comprising an infusion pump that provides infusion information related to one or more medications administered to a patient, the one or more medications which include sedatives and pain relievers, and a processor. communicably coupled to the infusion pump and configured to determine information regarding one or more medications that are administered to the patient based on the infusion information by determining a reference threshold for one or more medications that are administered to the patient according to with the actual dose of the one or more drugs administered to the patient before a current time, determining a dosage amount of one or more drugs that are currently being administered to the patient and comparing the dosage amount of one or more drugs that are being administered currently with the initial threshold to determine a deviation from the reference threshold. (Automatic translation with Google Translate, without legal value)

Description

DESCRIPTION

Analysis of patient care

Background of the invention

Field

The present disclosure generally relates to systems and methods that facilitate the optimization of patient care and, in particular, relates to the monitoring of patient sedation and pain therapy and the process of ventilator weaning of patients with ventilation.

Description of related subject

Mechanical ventilator patients, who are intubated in a care setting, typically receive sedation and pain therapy from an infusion pump, as well as life support from the mechanical ventilator device. Typically, a nurse operates the infusion pump and has overall responsibility for the patient. The respirator is usually used by a respiratory therapist.

The mechanical ventilator provides life support by assisting the patient with oxygen inhalation and CO2 exhalation to maintain the necessary arterial blood levels of PaO2, PaCO2 and pH, when the patient cannot maintain adequate levels with his own spontaneous breathing. Positive pressure mechanical ventilators pump air with a controllable percentage of inspired oxygen (21% - 100%) during the inspiratory phase of the respiratory cycle. When the inspiratory phase of the respiratory cycle is completed, the patient exhales through the ventilator using the natural recoil characteristics of the lungs. The volume of air that is drawn into the lungs in each cycle is the “tidal volume.” This process is highly invasive and has a high potential for complications such as baro trauma and secondary infections. Additionally, analgesics (or other pain medications) and sedatives commonly prescribed to these patients to provide patient comfort can lead to adverse outcomes for the patient.

Therefore, it is desirable to terminate the use of a mechanical ventilator as soon as possible. Many of the rules and protocols for transitioning a patient off a mechanical ventilator, or “weaning” the patient, include a series of clinical interventions including sedation and pain therapy management where the amount of sedatives and analgesics or other Pain medication is reduced to awaken the patient and allow the return of his natural respiratory drive. “Spontaneous awakening trials” or “Sedation holidays” where the patient is awakened as tolerated and monitored, and “Spontaneous breathing trials” or “Weaning trials” where ventilator support is reduced or stopped for a period of time and the patient is monitored during the trial to identify signs of distress or difficulty. If the patient is able to successfully complete the prescribed weaning trials, extubation can be performed where the ventilator is removed, or the patient can be placed back on full support to further prepare for extubation.

Such interventions that facilitate a complete dose reduction of analgesic and sedative medications, such as the use of nurse-controlled protocol-guided sedation, the combination of spontaneous awakening and breathing tests, and the use of short-acting medications, are associated with better results, such as decreased mechanical ventilation time and length of stay in the Intensive Care Unit (ICU). Titration of each patient's sedation during ICU admission is also managed to reduce oversedation and side effects, and contributes to reducing the duration of mechanical ventilation and length of stay.US 2010/121654 A1 refers to a system that manages pumps so that clinicians automatically receive alerts, decisions, and actions necessary to maintain a patient's medication therapy in accordance with a prescribed treatment protocol.

Brief description of the invention

Certain aspects of the disclosed method facilitate the management of rules and protocols for patient care. In certain embodiments, a method of monitoring patient care is provided. The method includes steps for determining a baseline threshold for one or more medications administered to a patient, one or more medications, including sedatives and pain therapy medications, the baseline threshold being calculated from an actual dose of one or more medications administered to a patient prior to a current time, determining the number of doses of one or more medications currently being administered to a patient, comparing the number of doses of one or more medications currently being administered currently administering with the baseline threshold to determine a deviation from the baseline threshold and generate information about the administration of medication to the patient based on the deviation from the baseline threshold.

In certain embodiments, a system is provided for determining compliance with one or more patient care rules and protocols. The system consists of an infusion pump that provides infusion information relating to one or more drugs delivered to a patient, wherein the one or more drugs include one or more sedatives and pain therapy drugs, and a processor communicably coupled to the pump. infusion and configured to determine information about one or more drugs to be administered to the patient based on the infusion information in accordance with a set of rules and protocols regarding the preferred method of care for the patient, the rules and protocols including rules for the administration of medication to the patient and generate analytics regarding patient care in accordance with the determined information and the rules and protocols.

In certain embodiments, a non-transitory computer-readable medium is provided that has executable instructions stored thereon for execution by a processor to determine compliance with one or more patient care rules and protocols. The method comprises the steps of receiving infusion information relating to one or more medications provided to a patient, the one or more medications, including sedatives and pain therapy medications, determining a set of patient care rules and protocols according to the type of patient and the patient therapy being administered to the patient, determine a variance between the infusion information and the rules and protocols for the patient, and provide one or more analyzes at least in part based on the variance.

Brief description of the figures

The accompanying drawings, which are included to provide further understanding and are incorporated into and constitute a part of this specification, illustrate the disclosed embodiments and together with the description serve to explain the principles of the disclosed embodiments. In the drawings:

Figures 1A and 1B depict exemplary hospital networks for collecting patient information and facilitating the management of rules and protocols for patients in accordance with aspects of the present disclosure.

Figure 2 illustrates an example process for providing information regarding compliance with patient care standards and protocols.

Figure 3 illustrates an example process for generating example infusion analyzes for a patient.

Figure 4 illustrates an example process for generating example ventilation analyzes for a patient.

Figure 5 illustrates an example process for determining whether the dosage of drugs administered to a patient complies with predefined rules and protocols.

Figure 6 conceptually illustrates an electronic system with which some implementations of the object technology are implemented.

Detailed description of the invention

The process of managing the care of a patient, such as a ventilated patient, to ensure optimal levels of sedation and pain therapy and/or adequate ventilation to minimize the side effects of oversedation or prolonged ventilation, it is essential to reduce the duration of ventilation. mechanics and/or length of stay, as well as the overall impact of patient care on short- and long-term patient status. To facilitate management of these issues, many critical care facilities, such as hospitals, ICUs, long-term acute care (“LTAC”) units, skilled nursing facilities, and/or other care facilities, may have one or more rules and protocols, such as best practice rule sets, sedation protocols, ventilation and weaning protocols, and other similar guidelines, to guide nursing and medical staff. In an example, one or more patient care rules and protocols are defined and/or communicated in accordance with best practice rule sets, predefined rules and protocols, and/or physician orders to provide care to patients (e.g., patients ventilated). As used herein, the phrase “rules and protocols” is generally used to refer to one or more orders (e.g., physician order), best practices, rules and/or protocols for providing care to patients. While several examples of the present disclosure are described with respect to a ventilated patient, it should be understood by one of those skilled in the art that many of the methods, systems and processes described herein can be applied to a variety of patients receiving care. .

Because compliance with patent care standards and protocols is intended to achieve optimal patient care outcomes, it is useful to facilitate periodic monitoring of whether these rules and protocols are being followed, and to provide management and updating of such rules. and protocols. Typically, such rules and protocols establish a set of steps to follow for each patient, including patients placed on a mechanical ventilator (“ventilated patient”), regarding dosing and titration of sedatives and pain medications ( for example, analgesics), the timing and frequency of spontaneous awakening trials or sedation vacations (“SATs”), the timing and criteria for performing spontaneous breathing trials (“SBTs”), and/or the timing and the criteria for extubation of the patient when mechanical ventilation is discontinued and the tube is removed from the patient.

These rules and protocols are typically implemented and/or communicated by physicians and/or care facility staff and supervisors to be followed by nurses and therapists. To monitor and improve compliance with such standards and protocols within a patient care facility or network, embodiments of the disclosed method and system provide for the receipt of information from one or more systems and machines, including the infusion pump that administers sedation. and pain therapy to the patient, the ventilator providing ventilation to the patient, the hospital information system, monitors, laboratory systems, or pharmacy and dispensing systems. In some embodiments, information is collected directly from these devices without requiring any interaction from the nurse or therapist and is used to generate analysis about the different steps of rules and protocols in relation to patient care, such as rules and protocols for ventilated patients with the goal of removing a patient from the ventilator. Other data, including, for example, patient demographics as well as patient status data, may also be collected and used to determine protocol compliance and best practices. In one example, in response to information collected from the infusion pump and/or ventilator, and optionally other mechanisms or entities, one or more analyzes may be generated. For example, compliance information can be generated that indicates whether nurses and/or therapists are taking the correct actions for optimal patient care. In an example, one or more bookmarks and/or notifications may be provided to the nurse and/or therapist in response to the collected data.

In some examples, multiple rules and protocols for patient care can be generated for all patients. In one or more cases, the rules and protocols may be customized and/or adjusted according to specific patient characteristics, so that specific rules and protocols are provided for different collections of patients who may require specialized or personalized care in accordance with different circumstances, including the characteristics of the patients or the type of therapy administered to the patient. These characteristics may include area of care, patient type, diagnosis-related group (DRG), or other categories defined based on patient characteristics. In one example, in addition to specific rules and/or protocols, various thresholds or markers may also be defined according to the type or patient or therapy and/or given patient category.

Measuring and driving compliance can allow clinicians to measurably optimize and improve patients' ventilator weaning. The collected data can be processed to generate various markers and/or analyzes that provide information on clinical intervention events and how the timing/pattern of these events affects the weaning process and facilitate a complete view of the weaning process, including sedation/weaning. pain therapy, SATs, SBTs and extubation, thus promoting better multifunctional teamwork between doctors, nurses and respiratory technicians.

In various examples, analytical data, including one or more markers and/or notifications, may be correlated with patient outcome information to determine the impact of various protocols and/or best practices on patient outcomes, and/or the impact of deviation from various protocols and/or best practices on patient outcomes. In one example, impact information can be used to modify protocols and/or best practices regarding patient care. Information on patient outcomes can be collected from various sources and may include information on patient weaning, discharge, readmission or complications and/or information on long-term patient status. Patient outcome information can be mapped to various markers that indicate deviation from protocols and/or best practices to determine the weight or importance of various protocols and/or practices.

Figures 1A and 1B represent an example of hospital network 100 for collecting patient information and facilitating the management of rules and protocols for patients. As shown in Figure 1A, the hospital network 100 includes an infusion pump 101, an infusion system manager 102, a ventilator 103, a network module 104, a hospital information system 105, and a coordination engine 106.

Infusion pump 101 provides sedation and pain therapy to a patient. In one example, infusion pump 101 represents a collection of one or more infusion pumps for providing medications, including pain medications or sedation, to a patient. In one example, the infusion pump 101 may include one or more channels, and each channel may provide at least one of a sedative or analgesic (e.g., analgesics) to the patient. As described above, the infusion pump is usually operated by a nurse.

The infusion pump 101 is coupled to the infusion system manager 102 and provides infusion messages to the infusion system manager 102. The infusion messages may, for example, indicate the start and end times of specific doses/rates of medication. administered to the patient. For example, each time the dose and/or rate of one or more medications (e.g., sedatives and/or analgesics) is modified in pump 101, an infusion message is generated by pump 101 and sent to the system administrator. infusion system 102. In one example, the pump 101 provides messages related to the type of medication, the dosage of the medication, and the bolus dose patterns of the medication administered at the pump 101. The administrator of the infusion system 102 can receive more information about the identification of the patient associated with the infusion pump 101 of the pump 101 or the hospital information system 105. The pump 101 and the infusion system manager 102 are represented as independent elements for exemplary purposes. In some embodiments, the functionality of the infusion system manager 102 may be integrated into the infusion pump 101.

Infusion system manager 102 processes infusion messages received from pump 101 and provides infusion information to coordination engine 106. In one example, infusion information provided to coordination engine 106 includes patient identification information (e.g. For example, patient ID), drug information (for example, drug type), infusion start and/or stop times for each drug, and doses and/or rates for each drug (for example, continuous infusion dose , bolus dosing patterns, etc.). Information may be provided for different medications administered at the pump 101, including sedation and pain therapy medication administered to the patient. The ventilator 103 also provides information to the coordination engine 106 through the network module 104. The ventilation information provided to the coordination engine 106 may include ventilation mode, respiratory rate, tidal volume, amount of oxygen, amount of peak respiratory pressure, activated alarms, and/or other ventilation information available on the ventilator 103. In one example, the ventilator 103 may also provide a calculation of respiratory rate over tidal volume. The calculation may be the respiratory rate, which represents the number of breaths taken in a given period of time (for example, 60 seconds) over the tidal volume, which represents the normal volume of air displaced between normal breathing and expiration when not additional effort is applied. Information from fan 103 is provided to coordination engine 106 through network module 104. In some examples, network module 104 may be integrated into fan 103. In one embodiment, fan 103, network module 104 or an independent element in communication with the ventilator 103 and/or the network module 104 may be present on the hospital network and configured to receive and/or process messages from the ventilator 103 before forwarding ventilation information to the coordination engine 106.

The coordination engine 106 may also receive patient "ADT information" from the hospital information system 105. The ADT (admission, discharge, transfer) information may include demographic information as well as patient status information. Patient demographic information may include, for example, patient sex, date of birth, attendance, admission and physician consultation, location, blood type, height and weight, date and time of admission, patient in/out. Information about the patient's status may include, for example, admission, discharge, transfer, registration, update information, and other similar information about the patient's status within the care facility.

In one embodiment, the coordination engine 106 is incorporated into any interface engine or application that aggregates data from one or more devices and systems and sends said data to an analytics application such as knowledge portal 111. In one example, the coordination engine 106 coordination 106 facilitates the processing, filtering and/or transformation of information received from one or more machines and/or systems, including the infusion system manager 102 and the network module 104, to facilitate the transfer of the data to a respiratory knowledge portal 111 for processing and analysis. In one example, the coordination engine 106 receives the information, processes the information, and generates actionable data elements for processing in the knowledge portal 111. In one embodiment, the coordination engine 106 is incorporated into a processor. United States Patent Application Publication US2012/239824 A1 (Serial No. 13/421,776), titled “SCALABLE COMMUNICATION SYSTEM,” filed March 15, 2012, filed January 31, 2013, describes an example coordination engine for use with this disclosure.

The coordination engine 106 is communicably coupled to a respiratory knowledge portal 111 of a data center 110. The data center 110 includes the knowledge portal 110 communicably connected to one or more client devices 112 and 113. The Data center 110 may be located remotely from the hospital network 100 or may be part of the hospital network 100. In an example, the coordination engine 106 and the knowledge portal 111 may be implemented within a single server or one or more servers connected in a communicable way with each other. In some examples, the functionalities of the coordination engine 106 and the knowledge portal 111 may be performed by a single application or by one or more applications that collaborate to perform one or more of the functionalities described herein with respect to the coordination engine. 105 and the knowledge portal 111.

In one example, the knowledge portal 111 receives the infusion and ventilation information from the coordination engine 106, and processes the information to generate one or more markers and analyzes and provide information regarding compliance with patient care rules and protocols. In some examples, the knowledge portal 111 may also compare patient care compliance information with patient outcome information (e.g., ADT information, long-term patient status information, readmission information, etc.). .) to determine outcome correlations with various rules and protocols. Correlation information can be used to determine various modifications or improvements to patient care rules and protocols and/or to mark various rules and/or protocols as important based on the impact of compliance on patient outcomes.

Knowledge portal 111, in some embodiments, is implemented as an application that receives information from one or more devices, such as pump 102 and ventilator 104, within a hospital network 100, and analyzes the data to provide analytics. In one embodiment, the respiratory awareness portal 111 is incorporated into a processor. United States patent application serial number 13/756,421 entitled “RESPIRATORY KNOWLEDGE PORTAL,” filed on January 31, 2013, describes an example of a respiratory knowledge portal for use with the present disclosure.

The knowledge portal 111 may, for example, have access to a set of predefined rules and protocols (e.g., best practices). Rules and protocols can be defined based on historical data and/or manually by the contact center or other entity. In one example, rules and protocols may be defined based on specific patient groups or characteristics. Using the infusion and/or ventilation information received from the coordination engine 106, the knowledge portal 111 may determine one or more markers corresponding to the preferences defined by the rules and protocols. The knowledge portal 111 may be configured to measure variability from predefined rules and protocols and may provide one or more analyzes regarding the variation of the rules and protocols (e.g., reports, notifications, etc.) to one or more entities (for example, care center supervisors, nurse, respiratory therapist, etc.).

In one example, a library (e.g., a drug library) is accessible by knowledge portal 111. The drug library may include a master drug list that identifies drugs by name or identifier. In one example, knowledge portal 111 may be configured with drug type information for drugs included in the master list. For example, for one or more drugs on the master list, the knowledge portal 111 may have access to data that identifies the type of drug as a pain therapy drug (e.g., analgesics) or a sedative. In one example, the designation of drug types is performed by an entity such as the care facility or another third-party entity.

As part of the rules and protocols, the 111 knowledge portal may receive information indicating the preferred medications for a patient. In some examples, a preferred list of medications may be provided. The preferred list of drugs can be defined in terms of individual drugs, combinations of drugs (for example, a preferred pair of drugs). Preferred drugs may be based on specific patients to whom the drug is administered. For example, rules and protocols may specify the preferred pain therapy and sedative drugs for a patient. In other examples, preferences may include a preferred dose and/or dose ratios for each pain and sedative therapy. In some embodiments, the rules and protocols specify a preferred combination of pain therapy and sedation. The drug combination may be specified to ensure the correct combination of specific drugs and/or the dosage of said drugs.

Drug preferences can be defined based on specific patient characteristics and can be defined per patient or for a group of patients who share similar characteristics. In one example, a list of preferred medications may be provided by patient type or therapy. Specific patient characteristics may include demographic information such as the examples provided herein. In some examples, as described above, patient groups may be defined by characteristics such as area of care, patient type, DRG, or other similar characteristics. The knowledge portal may have access to information on limits (for example, hard and soft limits) for one or more drugs included in the master list. In one example, the library includes drug information for each drug, including the drug name and identifier, the drug type, and/or the drug limits. In some examples, the drug library may include additional information about the drugs, including, for example, the half-life of the drug, which refers to the duration of the drug's effectiveness (for example, the duration before the drugs wear off). .

Additionally, the rules and protocols may include weaning rules and protocols, the definition of preferences regarding SATs and SBTs, including the timing, frequency and/or duration of SATs and SBTs, prerequisites for SBTs, such as completion of a SAT within a predefined time period, and other patient data that may indicate whether the patient is a good candidate for an SBT and/or weaning (e.g., patient vital signs, satisfactory SATs , etc.), and/or rules regarding extubation, including the timing of extubation and/or prerequisites such as a successful SBT performed within a specific period of time from extubation and other patient data that may indicate whether the patient is a good candidate for an SBT and/or weaning (e.g. patient vital signs, etc.).

Based on the defined rules and protocols and the available information about the drugs in the master list, and the infusion and ventilation information received from the coordination engine 106, the knowledge portal 111 can determine the infusion and ventilation analysis. Infusion and ventilation analyzes can provide information on variation from predefined rules and protocols.

Figure 1B shows an alternative example of hospital network 100 for collecting patient information and facilitating the management of patient rules and protocols. The hospital network 100 of Figure 1B is similar to that of Figure 1A, but represents additional systems and machines that can provide information used, in addition to infusion and ventilation information, in generating analytics in the knowledge portal 111.

The coordination engine is further coupled to the monitors 107 (e.g., vital signs monitors), the dispensing system 108 (e.g., a pharmacy system and/or dispensing machines), and the laboratory system 109. The coordination engine coordination receives information about medications, patient status, and vital signs, from one or more machines and/or systems, including, but not limited to, monitors 107, dispensing system 108, and laboratory system 109 (e.g., a pharmacy). In an example, other information about the patient, including neurological evaluation information, may also be provided in the knowledge portal 111. Vital signs and other data may be used by the knowledge portal 111 at various stages of the described processes. herein to determine analyzes regarding variation in rules and protocols that define best practices, as well as to provide indicators of when a patient is a good candidate for weaning (e.g., one or more of an SBT or extubation ) in addition to various markers and analyzes described herein.

In an example, the knowledge portal 111 is coupled to the client devices 112 and 113 and provides the determined metrics and analyzes for display on one or more client devices 112 and 113. In an example, the metrics and analyzes can be provided such as notifications or warnings to nurses, respiratory technicians, or other care providers (for example, when a deviation from preferred rules and protocols is recognized, or when a preferred event must occur). In another example, one or more of the markers and analyzes may be provided to those in a supervisory role to provide an overview of the process, identify problems in the actual weaning processes and patient care, and provide information about the pattern of events that lead to optimal outcomes with respect to a patient. Metrics and analytics may be analyzed and provided in real time or near real time for display on client devices 112 and 113. In one example, the analytics may be used to provide decision support to perform patient care. with respect to patients. In some embodiments, the knowledge portal 111 may provide the metrics and analytics to the client devices 112 and 113 over a wired or wireless network or communication channel.

In addition to infusion information and ventilation information, analytics generated in Knowledge Portal 111 may be generated based on other machine data that provides patient information and vital signs, from one or more machines and/or systems, including , but is not limited to, for example, monitors 107, dispensing system 108 (e.g., a pharmacy system and/or dispensing machines) and laboratory system 109. Vital signs and other data may be used by the portal knowledge 111 at various stages of the processes described herein to determine analysis regarding the variation of the rules and protocols that define best practices, as well as, to provide indicators of when a patient is a good candidate for weaning (e.g. example, one or more of an SBT or extubation) in addition to various markers and analyzes described herein.

Figure 2 illustrates an example process 200 for providing information regarding compliance with patient care standards and protocols. In one example, the patient may be a ventilated patient, however, various steps of the process may also be performed with other patients, including patients who do not require ventilatory care. In step 201, infusion information regarding drugs administered to a patient is received at knowledge portal 111. The information may be provided from an infusion pump (e.g., infusion pump 101 and/or system manager infusion 103). The information may include patient identification, types of medications administered to a patient, dosage and/or rates of medications, as well as infusion initiation, discontinuation.

In step 202, ventilation information relating to the ventilation provided to the patient is received at the knowledge portal 111. The information may be received from a ventilator (e.g., ventilator 103). The information may include ventilation mode, respiratory rate, tidal volume, respiratory rate divided by tidal volume, percentage of inspired oxygen (for example, within a range of 21% to 100%), the amount of peak inspiratory pressure, alarms that are activated and/or any other ventilation information available on the ventilator. In other embodiments, information is provided from additional systems, as discussed above.

In step 203, one or more rules and protocols related to patient care are identified. In one example, rules and protocols define best practices for removing patients from mechanical ventilation. Rules and protocols may be predefined by an entity such as the contact center or another entity that has knowledge of best practices.

The rules and protocols identified in step 203 may, for example, include rules and protocols related to medication or medications administered to patients. In one example, the information indicates the preferred drugs for a patient. For example, rules and protocols may specify the preferred pain therapy and sedative drugs for a patient, as well as a preferred dose and/or dose ratios (e.g., the ratio of sedative or analgesic drugs for each patient) for such patients. drugs. The rules and protocols may also include limits (for example, soft or hard limits) for one or more drugs administered to a patient. Additionally, the rules and protocols may include weaning rules and protocols, including rules and protocols on SATs, SBTs and extubation including time, frequency, duration and/or preceding or following events.

In step 204, one or more markers are calculated according to the information received in steps 201 and/or 202. In some embodiments, one or more markers may also be generated based on the information received from the hospital information system 105. , the monitors 107, the dispensing system 108 and the laboratory system 109. One or more markers may correspond to desirable values and events defined by the rules and protocols identified in step 203. For example, one or more markers may include the identification of drugs administered to a patient, weight-based doses of drugs administered to a patient, information regarding bolus doses, and the occurrence and timing of one or more SATs, SBTs, and extubation.

In step 205, infusion and/or ventilation analyzes are generated by comparing one or more markers to rules and protocols to determine a best practice variation. For example, drugs administered to a patient, as well as drug doses, are compared to rules and protocols to determine whether preferred drugs are administered to a patient at preferred doses and within predefined limits. In one example, as described above, a list of preferred medications may be provided (e.g., by patient type or therapy). The drugs administered to the patient can be compared to the preferred drug list to determine if the preferred drugs are administered to the patient. In one example, dosing information relating to drugs being administered to the patient is determined and compared to threshold values to determine whether the correct dose of the drug is being administered to the patient.

Additionally, in some examples, it is determined whether the SATs are administered in accordance with best practices, including the timing and frequency of the SATs, and whether the SATs are successful based on at least the duration of each SAT. Additionally, in some examples, it is determined whether SBTs are performed in accordance with rules and protocols, including whether a patient who is a good candidate for weaning undergoes an SBT and whether the prerequisites for an SBT are met, as well as like the success of the SBT. Additionally, it can be determined whether a patient's extubation is being performed in accordance with the rules and protocols, including the timing of extubation and the extubation prerequisites that are being met. An example process for generating infusion analysis is described in more detail below with respect to Figure 3. An example process for generating ventilation analysis is described in more detail below with respect to Figure 4.

In step 206, one or more analyzes are provided for display on a client device. In one example, analytics are provided as notifications to one or more entities, such as a nurse or respiratory therapist. In another example, the analysis may be provided in one or more reports to one or more users in a monitoring role.

Figure 3 illustrates an example process 300 for generating example infusion analyzes for a patient.

In step 301, the identification and dosage information of each drug administered to the patient is identified. As described above, with respect to Figure 2, the identification and dosage information is determined based on the information provided by the infusion pump. In one example, a drug library that includes a master list of drugs is used to identify drugs by name and/or identifier. The infusion pump 101 provides the name and/or identifier of the drug administered to the patient in the infusion pump 101. The drug dosage information may be a weight-based dose of each drug administered to the patient calculated according to the information dosage of each administered drug as provided by the infusion pump, and a patient weight that is provided as part of the ADT information relating to the patient. In one example, the dose information may include a number of doses of the medication administered at a given time or in a given period of time, or a cumulative dose. In some examples, the number of doses may be determined based on the scheduled dose and/or bolus doses that are administered to the patient (e.g., over a period of time).

In step 302, it is determined whether the drugs administered to the patient are the preferred drugs as defined by the rules and protocols. In one example, the rules and protocols define the specific preferred sedative and pain therapy drugs to be administered to the patient. For example, rules and protocols may specify the preferred pain therapy and sedative drugs for a patient on a ventilator. In one example, preferences may be defined based on specific patient characteristics (e.g., patient type or therapy type). Determining which drugs are defined as preferred drugs for the patient can be made by determining the specific characteristics of the patient and determining the preferred drugs for the patient based on the characteristics.

In step 303, it is determined whether the correct dose of each medication is administered. Rules and protocols may specify the preferred dose and/or dose ratios for pain therapy and sedative drugs for a patient on a ventilator. In one example, weight-based doses of each drug, as identified in step 301, are used to determine whether the dose of each drug meets defined dosage preferences. Bolus doses can also be analyzed to determine if the patient is being overmedicated.

A dose ratio can be calculated based on the weight-based doses of sedative and pain therapy medications. In one example, the ratio defines a relationship between the amount (dose) of a sedative administered to a patient and the amount (dose) of a pain therapy medication administered to the patient. The calculated dose ratio is then compared to the preferred dose ratio as defined by the rules and protocols to determine if there is a variation between the calculated dose ratio and the preferred dose ratio.

In step 304, it is determined whether the dose of the administered drugs is within a predefined limit. For example, information regarding the limits (e.g., soft or hard limits) of one or more drugs can be accessed and compared to the doses of each drug to determine whether the doses are within the limits of that drug.

In another example, the determination may be based on a baseline threshold calculated for the specific patient (or a group of patients). In one example, the baseline threshold may be determined according to the dose patterns administered to the patient (or other similar patients), for example, over a period of time. The doses identified in step 301 can be compared to the baseline threshold to determine whether the administered dose is an adequate dose. Figure 5, described in more detail below, illustrates an example process for determining whether the dose of drugs administered to a patient complies with predefined rules and protocols.

As described above, drug dose limits and thresholds can be defined according to different patient characteristics. In an example, the patient may be determined to be within a patient category according to various criteria (e.g., patient and treatment characteristics), and rules and protocols, including preferred drugs, limits, thresholds, and other Compliance information for the patient can be determined based on the patient category.

In one example, drug limits, thresholds, rules and/or protocols can be determined and/or modified according to the drug type and/or drug half-life information. In one example, each drug may be associated with a half-life, and one or more rules and protocols, limits, thresholds, or measurements may be modified according to the half-life information of a drug that is administered to the patient. As described above, half-life information indicates an effective duration of a drug. In one example, the timing of various rules and protocols (e.g., when medications should be administered, when the patient should be weaned from medications and/or ventilation, etc.) can be modified according to the half-life information.

In step 305, infusion analyzes are generated according to the determinations in steps 302, 303 and 304.

In one example, the analysis may be provided to show one or more nurses, or supervisory staff. In some examples, the analyzes may be correlated with patient outcome information to determine a correlation between specific infusion practices and patient outcomes.

Figure 4 illustrates an example process 400 for generating an example ventilation analysis for a patient.

At step 401 it is determined whether one or more SATs were performed with respect to the patient. In order to perform SATs or sedation holidays, the dose of sedation and pain therapy medication administered to a patient is typically reduced (e.g., to a lower dose or discontinued). In step 401, the dosing information and infusion starts and stops provided by the infusion pump 101 to the coordinated engine 106 and the knowledge portal 111 are analyzed to identify the SATs. That is, changes in dose and/or start/stop of the dose are analyzed and when the dose is reduced to a level that indicates a SAT (e.g., reduced or stopped), a marker is generated indicating the start of a SAT. Doses following the marker are then analyzed until a dose increase is observed to a level that indicates termination of a SAT (e.g., an escalation or reset). Next, another marker is generated indicating the completion of the SAT. Instead of an increase in dose, indicating a termination of a SAT, in some cases a SAT may be followed by an SBT. In such cases, a marker may be generated once an SBT is initiated, to indicate the termination of a SAT.

If, in step 401, one or more SATs are identified, in step 402, it is determined whether the SATs are performed in accordance with the rules and protocols. For example, rules and protocols may define the preferred time, frequency and/or duration of SATs. For example, rules and protocols may define that SATs must be taken one or more times a day and/or preferred times to take SATs. SAT markers are used to determine the frequency of SATs and/or the timing of each SAT performed. The determined frequency and/or timing is then compared to the frequency and/or timing defined by the rules to determine if there is a variance between the actual frequency and/or timing of the SATs performed and the preferred frequency and/or timing of the SATs. .

Additionally, rules and protocols may define a preferred duration. The start/end markers for each SAT can be used to determine the length of the SAT. The duration is compared to the defined preferred duration. In one example, the preferred duration indicates that an SAT was successful. If, in step 401, no SAT is identified, the process continues to step 403.

As described above, the rules and protocols regarding SATs can be determined and/or adjusted according to various criteria, including the specific characteristics of a patient or the therapy that is administered to the patient (e.g., patient category ) and/or the specific drugs that are administered to the patient (for example, information on the half-life of the drug). For example, the time and/or duration of a<s>A<t>can be adjusted depending on the specific type of patient or type of therapy. Additionally, the time and/or duration of the SAT can be adjusted according to the specific type of drugs administered to the patient. For example, half-life information regarding the drug can be used to determine the appropriate timing/duration for a SAT based on the effective period of pain therapy and sedatives administered to the patient.

In step 403, it is determined whether one or more SBTs were performed with respect to the patient. When an SBT is performed, the fan 103 is put into a different mode to perform the SBT. The mode information provided by the fan 103 is analyzed to determine when a change in the indicative mode of a s Bt occurs. A marker is generated when such a change is detected, marking the beginning of the SBT. The ventilator information is then analyzed to identify an SBT termination. A termination of an SBT may be indicated by a change in the mode of the ventilator 103 or by the termination of ventilation indicative of an extubation. A marker is generated when an SBT termination is identified.

If, in step 403, one or more SBTs are identified, in step 404, it is determined whether the SBTs are performed in accordance with the rules and protocols. In an example, the rules and protocols may include rules regarding the preferred time, frequency and/or duration of SATs. Additionally, the rules may indicate one or more prerequisites before the SBT is performed.

For example, rules may define that once a patient is determined to be a good candidate for an SBT (e.g., a weaning candidate), an SAT should be performed and after a predefined period of time the an SBT. SBT markers are used to determine the timing and duration of the SBT. Additionally, the marker for the previous SAT is used to determine the amount of time before an SBT is started after the SAT, and whether the SBT is successfully completed.

Rules and protocols may also define a preferred duration for an SBT. The start/end markers of each SBT can be used to determine the duration of the SBT. The duration is compared to the defined preferred duration. In one example, the preferred duration indicates that an SBT was successful.

Furthermore, successful SBT (e.g., defined by a specific duration) in patients who are good candidates for weaning should be followed by extubation within a predefined time period from when SBT was initiated. The markers are used in conjunction with markers indicating extubation to determine the time between successful SBT and extubation in certain patients.

The information is then compared to SBT rules and protocols to determine if there is a variance between the time, duration, and prerequisite of actual SBTs performed and the preferred time, duration, and prerequisite of SBTs. If, in step 403, no SAT is identified, the process continues to step 405.

In various implementations, the rules and protocols relating to SBTs may be determined and/or adjusted according to various criteria, including, for example, the specific characteristics of a patient (e.g., patient category) and/or specific drugs that are used. administered to the patient (for example, information about the half-life of the drug). For example, the time and/or duration of an SBT can be adjusted depending on the specific type of patient or type of therapy. Additionally, the time and/or duration of SBT can be adjusted according to the specific type of drugs administered to the patient. For example, half-life information regarding the drug can be used to determine the appropriate timing/duration for an SBT based on the effective period of pain therapy and sedatives administered to the patient.

In step 405, it is determined whether an extubation of the patient was performed. An extubation can be identified if a termination is detected in the ventilation information (for example, after a successful SBT). In one example, in response to detecting a termination of ventilation information, a marker indicating an extubation is generated. In one example, a time limit can be defined before an interruption of ventilation is interpreted as an extubation. The time limit may, for example, explain the patient's switch to a remote ventilator for several reasons.

If, in step 405, it is determined that an extubation was performed with respect to the patient, in step 406 it is determined whether the extubation was performed in accordance with the rules and protocols. For example, rules and protocols may define a time to perform extubation after a successful SBT is performed. Markers of SBTs and extubation can be used to determine whether an SBT was successfully completed and the time elapsed after the successful SBT (e.g., as defined by a specific duration), before extubation was performed. This information is then compared to the rules and protocols to determine if there is a variation between the timing and previous events of extubation and the defined rules and protocols for extubation.

In step 407, ventilation analyzes are generated according to the determinations in steps 401-406.

Accordingly, the system embodiments and methods disclosed provide processing information for one or more infusion pumps, ventilators, hospital information systems, monitors, dispensing systems, etc. and/or laboratory systems that provide information about a ventilated patient and analyze the information to evaluate protocol compliance and best practices. The information collected can be processed to generate various markers and/or analyzes that provide information on clinical intervention events and how the timing/pattern of these events affects the weaning process and facilitate a complete view of the weaning process, including sedation/weaning. pain therapy, SATs, SBTs and extubation, therefore driving better cross-functional teamwork between doctors, nurses and respiratory technicians. Measuring and driving compliance can allow clinicians to measurably optimize and improve weaning of ventilated patients. Additionally, the markers and analyzes generated can help provide information on how the patient outcome relates to the patient's actual outcomes.

In one example, analytics are compared to patient outcome information to determine how a certain activity (for example, following or deviating from certain rules and protocols, specific types of medications, or specific sets of activities related to patient care) is performing. relates to specific outcomes for patients. Correlation may occur for specific types of patients (for example, based on patient category and characteristics), or based on the specific types of therapy provided to patients. Comparison can provide specific outcome analyzes that provide information about the effectiveness of various practices in patient care.

In one example, the results information can be used to adjust various rules and protocols to achieve optimal results. In another example, the results information can be used to modify or adjust various thresholds, limits and criteria used to determine various analyzes described herein. In one example, the outcomes information may also be used to determine certain preferences, including, for example, preferred drugs that lead to optimal outcomes for certain patients, the preferences may be provided to the knowledge portal. In one example, therefore, the automatic generation and/or maintenance of rules and protocols is possible through the use of the analyzes described herein.

Figure 5 illustrates an example process 500 for determining whether the dose of drugs administered to a patient complies with predefined rules and protocols.

At step 501, rules regarding monitoring the medication dose for a patient are identified. In one example, a supervisory user may define rules to control the administration of medication doses (e.g., system administrator, care facility, etc.). In some examples, rules may be defined at the time of system configuration (e.g., knowledge portal) and may be updated according to various considerations (e.g., analysis and results reporting). In an example, the rules include an algorithm to determine a baseline threshold, time(s) to determine the baseline threshold, a threshold deviation from the baseline threshold, actions to be taken in case a deviation meets or exceeds the baseline threshold, and other criteria or rules related to controlling the dose of medication administered to a patient.

As described above, rules can be patient- or group-specific based on a category of patients (for example, patient type or therapy). In one example, the patient is identified and the characteristics of the patient and/or the therapy administered to the patient are compared to the defined categories, and the patient is associated with a specific patient category. Rules regarding dose monitoring can be identified for the user based on patient and/or patient category and/or therapy characteristics.

In one or more examples, one or more of the rules, algorithms, or values described for controlling dose administration may be defined in part based on the specific type of medication being administered to the patient. In one example, each drug can be identified and one or more values (e.g., threshold deviation, baseline threshold, etc.) can be identified and/or adjusted according to the specific identification of the drug. For example, as described above, in some examples, each drug may include half-life information and the rules identified in step 501 may be selected and/or adjusted according to the half-life information of the drugs being administered to the patient. .

In step 502, a baseline threshold is determined for the patient. The baseline threshold may be determined according to the rules determined in step 501. In some examples, the baseline threshold may include one or more values indicating a normal amount of medication that should be administered to the patient. In some examples, the baseline threshold may include a single value or a set of values. In an example, the baseline threshold may include a fixed value of the dose of medication that is administered to a patient in a specific time period or over a period of time. In some examples, the baseline threshold may include a maximum and/or minimum dose administered to a patient over a period of time. In one example, the baseline threshold may include a rolling average dose of medication being administered to a patient over a period of time.

In an example, the specific time or period of time for determining the baseline threshold can be defined according to various criteria. In some examples, the baseline threshold may be defined as a dose of each medication or a dose of all medications administered to a patient. In some examples, the baseline threshold may include a cumulative dose of medication (for example, including regular and/or bolus doses), a dose based on weight at a given time, or other dosing information indicating the medication actual administered to the patient.

In one example, a predefined set of rules can be established (for example, at the time of configuring the knowledge portal 11 1) that define the values (for example, algorithms for calculating values) that make up the baseline threshold. In one example, the baseline threshold algorithm can be customized based on patient type, category, specific drugs, or other characteristics of the patient, therapy, or facility of care.

In some examples, the specific time and/or time period used to determine the baseline threshold may be defined based on various criteria. For example, a time period or fixed time can be used. The fixed time period may represent a time period that is most likely to provide a fair representation of the appropriate dosage of medications that should be administered to the patient. For example, the time of day, the number of possible interruptions (e.g., operations, review hours), or other considerations may result in the designation of a time period (e.g., a three-hour interval) that would provide the most optimal time to measure a basal dose of the medication being administered to the patient. In another example, a pattern may be defined to select the time segment or time (for example, a pattern of a consecutive amount of time without interruption or with a fixed dose within a predefined threshold).

In one example, the optimal time period and/or the algorithm for determining the baseline threshold can be determined heuristically based on information provided by patients. For example, medication doses administered to a specific patient, category of patients, or all patients can be obtained and analyzed to determine the optimal time period for determining the baseline threshold of medication doses to be administered to the patient. In one example, drug administration patterns may, for example, be analyzed to determine optimal times to define or determine the baseline threshold of doses to be administered to the patient. Similarly, the algorithms used to determine the baseline threshold can be analyzed, for example, across multiple patients, patient categories, etc. to determine the optimal algorithms for calculating the baseline threshold, for one or more patients or groups of patients.

At step 503, dose information is determined, including the dose of the medication currently being administered to the patient. In one example, the dose information may be the dose of the medication at a specific time or may be a cumulative dose over a period of time. In one example, the dosage information may include bolus doses as well as continuous doses. In one example, dosing information may be determined according to information received from the infusion pump 101. The infusion pump 101 provides the drug name and/or identification for each drug administered to the patient in the infusion pump 101. The drug dosage information may be a weight-based dose of each drug administered to the patient calculated according to the dosage information of each administered drug as provided by the infusion pump, and a weight of the patient provided as part of the ADT information relating to the patient. In one example, the dose information may include a number of doses of the medication administered at a given time or in a given period of time, or a cumulative dose. In some examples, the number of doses may be determined based on the scheduled dose and/or bolus doses that are administered to the patient (e.g., over a period of time).

In step 504, the dose information is compared to the baseline threshold to determine whether the medication dose administered to the patient satisfies a condition with respect to the baseline threshold. In an example, the condition may include whether the actual dose of the medication administered to the patient varies by a certain threshold deviation from the baseline threshold (e.g., one or more values, including, for example, an overall moving average for the day and/or a specific time segment maximum). The condition, in an example, may be defined according to rules and protocols and may define a desired relationship with respect to a set of values defined by the baseline threshold.

In one example, the determination may generate a marker if there is a deviation from the reference threshold by a defined deviation threshold (e.g., above dose and/or below dose). In one example, as described above, the determination may include a separate determination for each drug, or a combination of one or more drugs (e.g., sedatives and/or analgesics) that are administered to the patient. In one example, the deviation threshold may be expressed in terms of a fixed value, a percentage and/or a cumulative value. For example, the threshold deviation may be a specific number of doses above (or below) the reference threshold. In another example, the threshold deviation may be expressed in terms of a percentage of the dose administered to the patient and/or a percentage of the baseline threshold. In some cases, the threshold deviation may be a cumulative dose amount in view of the reference threshold. As described above, the threshold deviation may be defined according to the rules determined in step 501.

In some examples, the comparison may be made with respect to a specific point in time or time segment (for example, a 3-hour time period). In some examples, the time periods for the comparison and/or the frequency of the determination and comparison of the process 500 may be defined according to the rules determined in step 501. In an example, the time periods and/or the frequency They can be adjusted according to the specific information or activity observed with respect to the patient (for example, if a deviation is observed, the frequency of comparison can be increased and/or the time segment for the comparison can be reduced).

In step 505, information regarding the medication being administered to the patient is generated according to the comparison. In one example, the information includes one or more notifications and/or markers that indicate deviation from the normal or acceptable dose of medication (e.g., as defined by the baseline threshold) administered to the patient. For example, a notification or flag is generated when the comparison indicates that the dose of medication administered to a patient at a certain time or period of time is above a deviation from the baseline threshold, which represents the normal dose of the medication that should be administered to the patient.

Figure 6 conceptually illustrates an electronic system with which some implementations of the object technology are implemented. The electronic system 600 may be a server, computer, telephone, PDA, laptop, tablet, television with one or more processors integrated or coupled thereto, or any other type of electronic device. Such electronic system includes various types of computer-readable media and interfaces to other types of computer-readable media. The electronic system 600 includes a bus 608, processing unit(s) 612, a system memory 604, a read-only memory (ROM) 610, a permanent storage device 602, an input device interface 614, an interface of output device 606 and a network interface 616.

Bus 608 collectively represents all system, peripheral, and chipset buses that communicatively connect the numerous internal devices of electronic system 600. For example, bus 608 communicatively connects processing units 612 to ROM 610, system memory 604, and the permanent storage device 602.

From these memory units, the processing unit(s) 612 retrieves the instructions to execute and the data to process in order to execute the subject disclosure processes. The processing units can be a single processor or a multi-core processor in different implementations.

The ROM 610 stores static data and instructions that are necessary for the processing unit(s) 612 and other modules of the electronic system. The permanent storage device 602, on the other hand, is a read-write memory device. This device is a non-volatile memory unit that stores instructions and data even when the electronic system 600 is turned off. Some implementations of the subject disclosure use a mass storage device (such as a magnetic or optical disk and its corresponding disk drive) as the permanent storage device 602.

Other implementations use a removable storage device (such as a floppy disk, a flash drive, and its corresponding disk drive) as permanent storage device 602. Like permanent storage device 602, system memory 604 is a memory device. reading and writing. However, unlike storage device 602, system memory 604 is volatile read-write memory, such as random access memory. System memory 604 stores some of the instructions and data that the processor needs at run time. In some implementations, the subject disclosure processes are stored in system memory 604, permanent storage device 602, and/or ROM 610. For example, the various memory units include instructions for determining compliance with one or more rules. and patient care protocols according to various implementations. From these memory units, the processing unit(s) 612 retrieves instructions to execute and data to process in order to execute the processes of some implementations.

Bus 608 also connects to input and output device interfaces 614 and 606. Input device interface 614 allows the user to communicate information and select commands to the electronic system. Input devices used with input device interface 614 include, for example, alphanumeric keyboards and pointing devices (also called cursor control devices). The output device interfaces 606 allow, for example, the display of images generated by the electronic system 600. The output devices used with the output device interface 606 include, for example, printers and display devices, such as tubes of cathode ray (CRT) or liquid crystal displays (LCD). Some implementations include devices such as a touch screen that function as input and output devices.

Finally, as shown in Figure 6, bus 608 also couples electronic system 600 to a network (not shown) through a network interface 616. In this way, the computer can be part of a network of computers. (such as a local area network (“LAN”), a wide area network (“WAN”), or an Intranet, or a network of networks, such as the Internet. Any or all of the components of electronic system 600 may be used together with the subject disclosure.

These functions described above can be implemented in digital electronic circuits, in software, firmware or hardware. The techniques can be implemented using one or more computer software products. Programmable processors and computers can be included or packaged as mobile devices. Logic processes and flows may be carried out by one or more programmable processors and by one or more programmable logic circuits. General and special purpose computing devices and storage devices can be interconnected via communication networks.

Some implementations include electronic components, such as microprocessors, storage, and memory that store computer program instructions on a machine-readable or computer-readable medium (also known as computer-readable storage medium, machine-readable medium, or computer-readable storage medium). ). Some examples of these computer-readable media include RAM, ROM, read-only compact discs (CD-ROM), recordable compact discs (CD-R), rewritable compact discs (CD-RW), read-only digital versatile discs (e.g. (e.g. DVD-ROM, dual-layer DVD-ROM), a variety of recordable/rewritable DVDs (e.g. DVD-RAM, DVD-RW, DVD+RW, etc.) flash memory (e.g. SD cards, mini-SD, micro-SD cards, etc.), magnetic and/or solid state hard drives, read-only and recordable Blu-Ray ® discs, ultra-density optical discs, any other optical or magnetic media and floppy disks. The computer-readable media may store a computer program executable by at least one processing unit and include sets of instructions for performing various operations. Examples of computer programs or computer code include machine code, as produced by a compiler, and files that include higher-level code that are executed by a computer, an electronic component, or a microprocessor using an interpreter.

While the above discussion primarily refers to microprocessor or multi-core processors running software, some implementations are realized by one or more integrated circuits, such as application-specific integrated circuits (ASICs) or field-programmable gate arrays (FPGAs). ). In some implementations, such integrated circuits execute instructions that are stored on the circuit itself.

As used in this specification and in any claim in this application, the terms “computer,” “server,” “processor,” and “memory” refer to electronic devices or other technological devices. These terms exclude people or groups of people. For the purposes of the specification, the terms display or display means display on an electronic device. As used in this specification and in any claim of this application, the terms “computer-readable medium” and “computer-readable media” are entirely restricted to tangible physical objects that store information in a form that is readable by a computer. These terms exclude any wireless signals, wired download signals and any other ephemeral signals.

To enable interaction with a user, implementations of the subject matter described in this specification may be implemented on a computer that has a display device, for example, a CRT (cathode ray tube) monitor or LCD (liquid crystal display), to display information to the user and a keyboard and pointing device, for example, a mouse or trackball, by which the user can provide information to the computer. Other types of devices can be used to provide interaction with a user as well; For example, the feedback provided to the user may be any form of sensory feedback, for example, visual feedback, auditory feedback or tactile feedback; and user input can be received in any form, including acoustic, voice or touch input. Additionally, a computer can interact with a user by sending documents and receiving documents from a device used by the user; for example, by sending web pages to a web browser on a user's client device in response to requests received from the web browser.

Implementations of the subject matter described in this specification may be implemented in a computer system that includes a back-end component, for example, such as a data server, or that includes a middleware component, for example, an application server, or that includes a front-end component, for example, a client computer that has a graphical user interface or a Web browser through which a user can interact with an implementation of the subject matter described in this specification, or any combination of one or more of these back-end, middleware, or front-end components. System components can be interconnected using any form or medium of digital data communication, for example, a communication network. Examples of communication networks include a local area network (“LAN”) and a wide area network (“WAN”), an internetwork network (e.g., the Internet), and point-to-point networks (e.g., point-to-point ad hoc networks). ready).

The computer system may include clients and servers. A client and a server are generally remote from each other and usually interact over a communication network. The client and server relationship arises by virtue of computer programs that run on the respective computers and that have a client-server relationship with each other. In some implementations, a server transmits data (e.g., an HTML page) to a client device (e.g., in order to display data and receive input from a user interacting with the client device). Data generated on the client device (for example, a result of user interaction) can be received from the client device on the server.

In the detailed description above, numerous specific details have been set forth to provide a complete understanding of the present disclosure. It will be apparent, however, to one ordinarily skilled in the art that the embodiments of the present disclosure can be practiced without some of the specific details. In other instances, well-known structures and techniques have not been shown in detail so as not to obscure the disclosure.

The foregoing description is provided to enable any person skilled in the art to practice the various aspects described herein. While the above has described what is considered the best mode and/or other examples, it is understood that various modifications to these aspects will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other aspects. . Therefore, the claims are not intended to be limited to the aspects set forth herein, but must be granted the full scope consistent with the linguistic claims, where reference to a singular element is not intended to mean "one and only" unless the opposite is specifically indicated, but rather “one or more.” Unless specifically stated otherwise, the terms “a set” and “some” refer to one or more. Pronouns in the masculine (for example, he) include the feminine and neuter gender (for example, she and her) and vice versa. Titles and subtitles, if any, are used for convenience only and do not limit the invention.

The specific order or hierarchy of steps in the revealed processes is understood to be an illustration of exemplary approaches. Depending on design preferences, it is understood that the specific order or hierarchy of steps in the processes can be reorganized. Some of the steps can be done simultaneously. The accompanying method states that it presents elements of the various steps in a sample order, and is not intended to be limited to the specific order or hierarchy presented.

Terms such as “up”, “down”, “forward”, “backward” and the like as used in this disclosure are to be understood as an arbitrary reference, rather than the ordinary gravitational frame of reference. Therefore, a top surface, a bottom surface, a front surface, and a back surface can extend up, down, diagonally, or horizontally in a gravitational frame of reference.

A phrase such as a “skin” does not imply that the skin is essential to the theme's technology or that the skin applies to all settings of the theme's technology. A disclosure related to an aspect may apply to all configurations, or to one or more configurations. A phrase such as an aspect can refer to one or more aspects and vice versa. A phrase such as an “embodiment” does not imply that such embodiment is essential to the subject technology or that such embodiment applies to all configurations of the subject technology. A disclosure relating to one embodiment may apply to all embodiments, or one or more embodiments. A phrase such realization may refer to one or more realizations and vice versa.

The word “exemplary” is used herein to mean “to serve as an example or illustration.” Any aspect or design described herein as “exemplary” should not necessarily be construed as preferred or advantageous over other aspects or designs.

Claims (14)

1. System to determine compliance with one or more patient care protocols, which includes: an infusion pump that provides infusion information relating to one or more drugs administered to a patient, wherein the infusion information indicates the start and end times of one or more drugs previously administered to the patient; and a processor communicably connected to the infusion pump and configured to: receive a set of rules and protocols regarding a preferred method of patient care; determining, for one or more drugs administered to the patient, a consecutive time pattern without interruption or with a fixed dose within a predetermined threshold of the infusion information; determine a baseline threshold for one or more drugs administered to the patient according to the actual dose of one or more drugs administered to the patient during a previous time segment based on the pattern of the consecutive amount of time without interruption or with the fixed dose; determining a number of doses of one or more drugs that are currently administered to the patient; comparing the number of doses of one or more drugs currently being administered to the baseline threshold to determine a deviation from the baseline threshold; and generate analysis regarding patient care, including information regarding the administration of medications to the patient according to the deviation from the baseline threshold; and provide, over a network, for display on a client device, the generated analyzes and, when the deviation indicates that the number of doses during a certain period of time is above a deviation from the reference threshold: provide, to a client device associated with a healthcare professional and remote from the processor, a notification regarding the deviation; and increase the frequency of comparison or decrease the time period given to compare future dose amounts given to the patient. 2. The system according to claim 1, wherein the baseline threshold is one or more of a maximum, minimum or a moving average of the number of doses of one or more drugs administered to the patient during a time period of accordance with the rules and protocols. 3. The system according to claim 1, wherein the processor is further configured to: determine one or more characteristics of the patient; determine one or more characteristics of the therapy being administered to the patient; and determining a patient category of the patient according to one or more characteristics of the patient and the therapy; and identify rules and protocols based on the given patient category. 4. The system according to claim 1, wherein the processor is further configured to: determine the half-life information of each of the drugs administered to the patient; and modify one or more of the rules and protocols according to the half-life information. 5. The system according to claim 1, wherein determining the information further comprises: determine a set of preferred medications according to rules and protocols; and compare one or more drugs administered to the patient with the preferred set of drugs; wherein the analyzes include information on whether one or more medications administered to the patient are preferred medications. 6. The system according to claim 1, wherein the processor is further configured to: determining a set of patient outcomes data for the patient, the outcome data that defines the outcome of care for the patient; correlate outcome data with patient care-related analytics generated for the patient; and generate analysis on the effect of the set of rules and protocols on the outcome of patient care. 7. A non-transitory computer-readable medium having executable instructions stored thereon for execution by a processor to carry out a method of determining compliance with one or more patient care protocols, the method comprising the steps of : receiving infusion information relating to one or more drugs previously administered to the patient, wherein the infusion information indicates the start and end times of one or more drugs previously administered to the patient; determine a set of rules and protocols that specify the preferred dose or preferred dose ratios; determining, for one or more drugs administered to the patient, a consecutive time pattern without interruption or with a fixed dose within a predetermined threshold of the infusion information; determine a baseline threshold for one or more drugs administered to the patient according to the actual dose of one or more drugs administered to the patient during a previous time segment based on the pattern of the consecutive amount of time without interruption or with the fixed dose; determining a number of doses of one or more drugs that are currently administered to the patient; comparing the number of doses of one or more drugs currently being administered to the baseline threshold to determine a deviation from the baseline threshold; providing, over a network, for display on a client device, one or more analyzes at least in part based on deviation, wherein the analyzes include information about the administration of medications to the patient according to the deviation from the threshold of reference; and providing, over the network, for display on the client device, when the deviation indicates that the dosing amount over a certain period of time is above a baseline threshold deviation, to an associated client device with a healthcare professional and remote from the processor, a notification regarding the deviation; and increasing a comparison frequency or decreasing the given time period for comparing future dose amounts administered to the patient. 8. The non-transitory computer-readable medium according to claim 7, wherein the set of rules including an algorithm for determining the baseline threshold. 9. The non-transitory computer-readable medium according to claim 8, wherein the algorithm for determining the baseline threshold is determined heuristically. 10. The non-transitory computer-readable medium according to claim 8, wherein the set of rules and protocols include a list of preferred medications. 11. The non-transitory computer-readable medium according to claim 10, the method further comprising: comparing one or more provided drugs to the list of preferred drugs to determine whether each of the provided drugs is a preferred drug. 12. The non-transitory computer-readable medium according to claim 7, wherein the reference threshold is one or more of a maximum, minimum or a moving average of a number of doses of one or more medications provided during the segment of time. 13. The non-transitory computer-readable medium according to claim 7, wherein the method further comprises determining a dose amount of medication that is currently being administered by calculating a weight-based dose of each of the medications provided based on at least partly in the infusion information. 14. The non-transitory computer-readable medium according to claim 13, wherein the number of doses of the medication currently being administered comprises one or more of a continuous dose and a bolus dose of the medication currently being administered during a period of time.